CHRYSALIS – NPI #1407077613
Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

Health Care Provider Taxonomy Code for Residential Treatment Facility, Intellectual and/or Developmental Disabilities

CHRYSALIS is a residential treatment facility located in SOUTHGATE, MI. NPPES has assigned the NPI number 1407077613 to CHRYSALIS on May 02, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 320600000X from the Health Care Provider Taxonomy code set, which is classified as Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

The NPI profile was previously updated about 6 years ago on Aug 22, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CHRYSALIS below.

NPI Profile for
CHRYSALIS

NPI Number
1407077613
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CHRYSALIS
Primary location
12985 NORTHLINE RD STE 103
SOUTHGATE, MI 48195-1194
Phone: (734) 282-4630 Fax: (734) 282-4684
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
MARIBETH KNISLEY
EXECUTIVE DIRECTOR
Phone: (734) 282-4630
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320600000X
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.